The New York State Department of Health is leading a collaborative effort to evaluate the public health system in its preparation, response, and recovery from Hurricane Sandy, and to research modifications needed to improve future response and recovery. Nine NYS counties and New York City (NYC) were declared as disaster areas after Sandy. The Long Island counties of Nassau and Suffolk suffered direct hits, as well as Westchester north of NYC. Collectively, the health departments in these three counties serve almost three million residents, with an additional million residents served by another six affected counties. Many local health department offices and public health service providers were closed due to power outages or hurricane damage. NYSDOH was required to assume surveillance, investigation, and control activities for notifiable diseases in Nassau County. Two large drinking water systems received infrastructure damage sufficient to interrupt their ability to deliver water to customers. Aim 1 wll focus on evaluating the public health system, addressing business processes in Objective 1.1, critical information needs in Objective 1.2, and public health system integration in Objective 1.3. Aim 2 will evaluate the impact on select community service providers, including public drinking water suppliers in Objective 2.1, HIV/STD community service providers in Objective 2.2, and WIC providers in Objective 2.3. Each objective has two parts. The outcome for part (a) is a research report evaluating the Sandy impact, and the outcome for part (b) is the research summary of needed modifications to build resiliency for future disasters. NYSDOH will analyze pre-existing data sources such as after action reports and Integrated Health Alerting and Notification System records using content analyses. Executive orders and regulation waivers (federal and state) will be reviewed. Primary data collection will include qualitative research using confidential one-on-one telephone interviews with key informants and meetings with focus groups, prioritizing counties with greatest impact. Primary data collection through quantitative surveys will also be extended to all counties in the disaster area. State and local health and emergency management departments will be included in the assessments. Seventeen key staff roles in health departments and four key staff roles in emergency management departments have been identified for participation. All scientific research and data collection, management, and analysis will be conducted as approved by the NYSDOH Institutional Review Board to assure informed consent and confidentiality. All research activities will be overseen by a Guidance Team with academic, local, and state representatives.